ICD-10 Coding for Achilles Tendinitis(M76.6, M65.271)
Complete ICD-10-CM coding and documentation guide for Achilles Tendinitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Achilles Tendinitis
M76-M77Primary Range
Soft tissue disorders related to use, overuse and pressure
This range includes codes for tendinitis and related soft tissue disorders, specifically covering Achilles tendinitis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M76.6 | Achilles tendinitis | Use this code for non-calcific Achilles tendinitis with typical symptoms and clinical findings. |
|
| M65.271 | Calcific tendinitis of right shoulder | Use this code when calcification is confirmed by imaging. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for Achilles tendinitis
Essential facts and insights about Achilles Tendinitis
Primary ICD-10-CM Codes for achilles tendinitis
Decision Criteria
clinical Criteria
- Presence of pain 2-6 cm above heel, morning stiffness, and positive Royal London Hospital Test
Applicable To
- Achilles tendon inflammation
- Non-calcific Achilles tendinitis
Excludes
- Achilles tendon rupture (S86.0-)
Clinical Validation Requirements
- Pain located 2-6 cm proximal to the Achilles insertion
- Morning stiffness lasting more than 30 minutes
- Positive Royal London Hospital Test
Code-Specific Risks
- Confusing with calcific tendinitis if calcification is not documented
Coding Notes
- Ensure documentation specifies laterality and absence of calcification.
M65.271 - Calcific tendinitis of right shoulder
Use this code when calcification is confirmed by imaging.
Applicable To
- Calcific deposits in Achilles tendon
Excludes
- Non-calcific Achilles tendinitis (M76.6)
Clinical Validation Requirements
- Radiographic confirmation of calcium deposits in the tendon
Coding Notes
Ensure imaging evidence of calcification is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Resistance to penicillins
Z16.21Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Strain of Achilles tendon
S86.4-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Achilles Tendinitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M76.6.
Impact
Clinical: Leads to ambiguity in treatment planning., Regulatory: Non-compliance with coding guidelines., Financial: Potential claim denials due to incomplete coding.
Mitigation Strategy
Always specify left or right in documentation.
Impact
Reimbursement: Incorrect coding can lead to denied claims or incorrect reimbursement., Compliance: Using incorrect codes can result in compliance issues during audits., Data Quality: Misclassification affects the accuracy of clinical data.
Mitigation Strategy
Ensure imaging confirms calcification before using M65.271.
Impact
Coding calcific tendinitis without radiographic evidence increases audit risk.
Mitigation Strategy
Ensure all cases of calcific tendinitis are supported by imaging documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Achilles Tendinitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Achilles Tendinitis
Use these documentation templates to ensure complete and accurate documentation for Achilles Tendinitis. These templates include all required elements for proper coding and billing.
Chronic Achilles Tendinitis with Calcification
Specialty: OrthopedicsRequired Elements
- Pain location and severity
- Functional limitations
- Imaging results
- Objective test findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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